Many Lessons Can Be Learned from the Amish Community

How EMS functions in a ‘simple’ way of life

 

 
 
 

Bryan Bledsoe, DO, FACEP, FAAEM, EMT-P | From the March 2012 Issue | Saturday, February 25, 2012


There’s something intriguing about insular societies. I’ve been fortunate to peek into some of them. Several years ago, I had the opportunity to visit Cuba. I’ve peered across the 38th parallel into North Korea, curious about what life is like on that side of the demilitarized zone.

Fortunately, after speaking at a conference in Harrisburg, Pa., I had the opportunity to spend a day with Amish EMS providers in Lancaster County, Pa. I had met several Amish EMTs at a previous EMS Today Conference & Exposition in Baltimore. In addition, I made contact with the managers of Lancaster EMS, the system serving Lancaster County, to help arrange a visit. Thus, as I made my way to Philadelphia from Harrisburg, I ended up spending one of the more enjoyable days of my life with some of the Amish EMTs who serve and protect portions of that county.

As I drove to Lancaster County, the green fields, simple farms and lush crops of the region captivated me. Amish farmers actually have a higher yield per acre than many traditional farmers. This is accomplished without significant use of mechanized farm implements and chemical fertilizers and pesticides. I passed a young Amish boy feeding horses and another group working in field. What a work ethic. I was impressed.

The Amish Culture
The Amish, like their Mennonite counterparts, are an Anabaptist religious sect. They’re colloquially referred to as the “plain people.” The roots of the Amish religion come from Germany, and the group is insular, meaning members of the church must marry within the faith. The church groups tend to be small and are governed by rules, referred to as the “Ordnung.”

Although these rules vary somewhat between groups, they generally forbid the use of electricity, telephones and automobiles. They also determine the type of clothing the members are to wear—generally, this means clothes that don’t draw attention. For the most part, contact between the Amish and the non-Amish world is restricted. The Amish are a peaceful group and do not participate in military service. They also don’t accept any form of government assistance or purchase insurance.

Members of the church collectively provide healthcare and other needs for their community. With severe injury and illness, the Amish will seek healthcare in traditional hospitals. Healthcare expenses are generally borne by members of the group. In many instances, because of the high costs of the U.S. healthcare system, Amish people often travel outside the U.S.—particularly Mexico—for costly surgical procedures and other treatments.

Education takes place in small schools, generally ends at or near the eighth grade and is taught in both German and English. The Amish people believe that this amount of education is all that is required for the simple lifestyle they enjoy.

The Community Mentality
I drove slowly into the hamlet of Blue Ball, Pa. It was a Saturday morning, and I passed several Amish horse and buggies along the way. I eventually located the restaurant, where I arranged to meet with local Amish EMTs for breakfast.

I introduced myself to approximately 14 EMTs from the Gordonville Fire and Ambulance Association. All showed up in their uniforms. After a great breakfast, we headed back to the fire station. The providers openly and honestly answered questions about their EMS system and their communities. My first question related to driving the ambulance. They all laughed and informed me that the Mennonite and non-Amish members drove the ambulance. We talked about training issues (they don’t use the Internet) and similar concerns regarding technology.

Like all EMS providers, they were eager to tell me about their system and interesting EMS calls. I sensed a spirit of cooperation among these men that I haven’t seen in a long time.

For example, I learned that approximately four days earlier a barn had burned down. On the day of my visit, the old barn had been cleared, and a new one was already going up. The costs, supplies and manpower were all provided by the community.

The Gordonville Fire and Ambulance Association is primarily a volunteer agency that serves the heart of the Amish country. When a call for a fire or EMS is received, a siren is sounded, and a non-Amish member of the department will drive a predetermined route to pick up the Amish members on the way to the station. The system seems to work well. The fire trucks have enlarged cabs to carry the extra manpower (often five to six members)—a necessary feature because the Amish can’t drive.

The service has three ambulances—one of which is staffed 24 hours a day, with the others being reserve units (but almost always available for back up if needed). Staffing during the day includes part-time paid staff and volunteer members. Gordonville typically responds to 800–1,000 calls a year. Most providers are EMTs. Despite the seeming limitations of such a system, the members are amazingly up-to-date on current EMS practices and controversies. We talked about various EMS issues, including IV fluids, helicopters and trauma care. I noted numerous issues of JEMS around the station and a copy of my paramedic text, Essentials of Paramedic Care open on the kitchen table with class notes nearby. At the end of my visit, a soft-spoken and blushing Mennonite member asked me to autograph her book.

Although Gordonville Fire and Ambulance is primarily BLS, ALS backup is provided by Lancaster County EMS—a world-class EMS operation that serves all of Lancaster County. The Amish and Mennonites know they live in an unusual community and trust their neighbors (and Lancaster County EMS) to provide needed care while respecting their privacy and beliefs.

After the meeting and a tour of the ambulance and station (of which they are very proud), I was allowed to ride in an Amish buggy. I visited a few residences and went to a shop where the buggies are made. I was also shown the location of the Nickel Mines Schoolhouse massacre that occurred on Oct. 8, 2006, hosted by the Amish incident commander on duty the day of that tragedy. The school was immediately razed after the shooting, and the site is unmarked—a testament to the Amish’s belief in forgiveness. I personally sensed that the Amish have somehow forgiven the shooter. I was both humbled and perplexed.

The day ended with a fundraiser at a neighboring fire department in Intercourse. Several hundred people—both Amish and non-Amish—were in attendance. The event was a community-wide endeavor to raise money for the Intercourse Fire Department. I was warmly greeted and left with an Intercourse Fire Department T-shirt, as well as various organic vegetables.

Being from the South, I have been exposed to agrarian communities and understand the concept of “community.” Although I haven’t spent a great deal of time in Pennsylvania, I know that the commonwealth has a large volunteer base and strong family values. I certainly witnessed this in Amish country.

As I boarded my plane home, I felt revitalized. I was able to witness simple people working hard, and with pride. They live for community; money comes second. What a contrast to Las Vegas, where everybody seemingly lives for money. I returned home feeling lucky. JEMS

This article originally appeared in March 2012 JEMS as “Simple Way of Life: EMS in the Amish Country.”



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Related Topics: Patient Care, Special Patients, Pa., Lancaster County, Intercourse Fire Department, Bryan Bledsoe, Amish, Jems Features

 
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Bryan Bledsoe, DO, FACEP, FAAEM, EMT-PDr. Bledsoe is an emergency physician and Professor of Emergency Medicine and Director of the EMS fellowship at the University of Nevada School of Medicine in Las Vegas. He is the author of numerous EMS textbooks and articles.

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